Dysphagia score

The following dysphagia scoring system, first utilised by Mellow and Pinkas (Knyrim et al.1993), is useful for describing the results of stent insertion.

0 = able to eat normal diet / no dysphagia.

1 = able to swallow some solid foods

2 = able to swallow only semi solid foods

3 = able to swallow liquids only

4 = unable to swallow anything / total dysphagia

This system is useful in quantitating dysphagia pre and post laser and stenting where noone will have normal diet. However, according to this classification my own "normal" dysphagia score would be 1 as I chew my food and swallow a semi-solid bolus. Some people with a lax LOS can swallow more solid boluses than I can and thus achieve a score of 0.

In my postoperative patients I do not aim to achieve a score of 0 which I regard as an abnormal score. After fundoplication, myotomy or resection I aim for my patients to swallow a well chewed diet.

My standard of success is for the patient to be comfortable to go out to a restaurant and eat a meal in company without having to make excuses for being slow or to have to go to the bathroom to be sick.